Survey Text

1981
top
1981
Survey form view entire document:  text  image
1. During the 2 weeks outlined in red on that calendar, did -- take or use any:

k. Are there any other pills, ointments, or other types of medicines that -- has taken or used during that 2 week period? - Specific
[] Y
[] N

Note - Ask 2-5 only for those questions in 1a-k which were answered "Yes."
2. What is the main health problem for which -- took or used the (Medication)?